Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.81 / $105.49 / $213.37	Facility	26	$52.81	$105.49	$213.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.77 / $278.76 / $832.10	Professional		$178.77	$278.76	$832.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.97 / $52.81 / $147.84	Professional	26	$42.97	$52.81	$147.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.80 / $225.94 / $684.26	Professional	TC	$135.80	$225.94	$684.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.46 / $67.87 / $124.49	Professional	26	$40.46	$67.87	$124.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.19 / $476.86 / $674.37	Professional		$223.19	$476.86	$674.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.72 / $112.65 / $159.30	Professional	26	$52.72	$112.65	$159.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.47 / $364.21 / $515.05	Professional	TC	$170.47	$364.21	$515.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.97 / $68.97 / $68.97	Facility	26	$68.97	$68.97	$68.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.95 / $531.05 / $720.29	Professional		$297.95	$531.05	$720.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.17 / $111.07 / $162.96	Professional	26	$67.17	$111.07	$162.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.03 / $416.37 / $573.61	Professional	TC	$229.03	$416.37	$573.61
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $255.51 / $454.09 / $841.68	Professional		$255.51	$454.09	$841.68
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $107.27 / $198.83	Professional	26	$60.36	$107.27	$198.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $195.15 / $346.82 / $642.84	Professional	TC	$195.15	$346.82	$642.84
United Facility/Professional Professional Modifier Low / Median / High Price $303.57 / $344.08 / $622.95	Professional		$303.57	$344.08	$622.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.89 / $76.95 / $155.77	Professional	26	$52.89	$76.95	$155.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.28 / $266.56 / $461.44	Professional	TC	$233.28	$266.56	$461.44
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $190.78 / $236.94 / $355.41	Professional		$190.78	$236.94	$355.41
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $52.91 / $71.58	Professional	26	$44.14	$52.91	$71.58
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.32 / $175.58 / $277.13	Professional	TC	$146.32	$175.58	$277.13